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Tpa Operations Jobs (NOW HIRING)

Reliant

National Director of TPA Growth

OR · On-site +1

Lead multi-threaded sales cycles involving executive, claims, and operations leadership * Position ... TPA organizations * Strong executive presence and ability to navigate channel sensitivity and ...

WoodmenLife

Director, TPA Vendor Relations

Omaha, NE · On-site +1

$110K - $200K/yr

This role drives operational rigor, disciplined execution, and performance accountability across ... Ensure alignment of TPA services with operational priorities, service models, and customer ...

Hippo Insurance

Director, TPA Claims

Austin, TX · On-site

... Operations * Own quality assurance, file audits, and reserving accuracy for the TPA claims book, including full accountability for litigation strategy, defense counsel management, and litigation ...

woodmenlife

Director, TPA Vendor Relations

This role drives operational rigor, disciplined execution, and performance accountability across ... Ensure alignment of TPA services with operational priorities, service models, and customer ...

ClaimSorted Inc

Account Executive

New York, NY · On-site

$100K - $180K/yr

Knowledge of the insurance industry or TPA operations (a plus) Our Values * Move Fast - Act decisively, iterate quickly, optimise for momentum. * Always Overdeliver - We exceed expectations in ...

Hippo Insurance

Director, TPA Claims

Austin, TX · On-site

... Operations * Own quality assurance, file audits, and reserving accuracy for the TPA claims book, including full accountability for litigation strategy, defense counsel management, and litigation ...

Louisville Ballet

Managing Director

Austin, TX · On-site

The position is responsible for implementing the Executive & Artistic Director's strategic vision by leading daily operations, providing financial management, and guiding the work of TPA ...

VUMI Group

Director of TPA Relations

Miami, FL · On-site

POSITION SUMMARY The Director of TPA Relations is responsible for overseeing and optimizing the ... Partner with clinical, operations, provider network, and finance teams to ensure seamless ...

Navtech, Inc.

Claims Analytics Manager

Remote (PA) Duration : Long term Contract As a member of our TPA Operations team, the Manager, TPA Business Analytics will lead a team of Analytics and Metrics Specialists who are responsible for the ...

Personify Health

Account Manager, TPA

Tempe, AZ · On-site

$65K - $85K/yr

Why This Role Matters Account Managers in TPA environments aren't just relationship coordinators-they're operational lifelines who keep complex client relationships running smoothly through proactive ...

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Tpa Operations information

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$49

How much do tpa operations jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for tpa operations in the United States is $24.15, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $27.64 per hour, depending on experience, location, and employer.

What is the difference between Tpa Operations vs Claims Processing Specialist?

AspectTpa OperationsClaims Processing Specialist
CredentialsTypically requires insurance or healthcare administration certificationsOften requires claims processing or insurance certifications
Work EnvironmentWorks within third-party administrator companies, handling multiple client accountsWorks within insurance companies or third-party vendors, focusing on individual claims
Industry UsageCommon in healthcare, insurance, and third-party administrationPrimarily in insurance companies and claims processing firms

While both roles involve insurance and healthcare processes, Tpa Operations focuses on managing overall third-party administration functions, whereas Claims Processing Specialists handle specific claims submissions and adjudication. Tpa Operations professionals oversee broader operational tasks, ensuring compliance and client management, while Claims Processing Specialists concentrate on accurate claims review and processing.

What are popular job titles for Tpa Operations?

Popular job titles for Tpa Operations:

Infographic showing various Tpa Operations job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 79% Full Time, 17% Part Time, 1% Temporary, 1% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $50,239 per year, or $24.2 per hour.

Quality Assurance, Risk Control & Special Investigations Analyst

Dallas, TX • On-site, Remote

Bestow, Inc
Insurance Services • 201 - 500 employees
Learn more about Bestow, Incexternal

Full-time

Medical, Dental, Vision, Life, PTO

Posted 16 days ago

Job description

ABOUT BESTOW
Life insurance is one of the world's most important products. It's also one of the hardest to build, distribute, and modernize. Bestow exists to change that.
Bestow is a leading vertical technology platform serving some of the largest and most innovative life insurers. Our platform unifies the fragmented, legacy value chain, enabling carriers to launch products in weeks instead of years. Carriers choose us to scale and operate at unprecedented speed, powered by AI and automation.
Bestow isn't selling policies. We're building the infrastructure that helps an entire industry move faster, reach more people, and deliver on its promise.
Backed by leading investors (Goldman Sachs, Hedosophia, NEA, Valar, 8VC) and trusted by major carriers, Bestow is powered by a team that moves with precision, purpose, and heart. If you want to help reimagine a centuries-old industry with lasting impact, join us.
Bestow offers flexible remote/hybrid work, meaningful benefits, equity, and substantial growth opportunities.
Bestow uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify.gov.
ABOUT THE ROLE
The Quality Assurance, Risk Control & Special Investigations Analyst is a specialized and critical role responsible for ensuring operational integrity, service excellence, and adherence to regulatory standards across our life insurance Third-Party Administrator (TPA) operations. This individual performs three key functions: auditing call and service interactions, conducting pre-referral fraud investigations while providing supporting documentation regarding alleged fraud inquiries, and monitoring internal controls to drive process improvement and mitigate risk.
This role reports directly to the Customer Experience Manager and is open to hybrid in our Dallas office or Remote (US). #LIREMOTE
WHAT YOU'LL DO
  • Interaction Auditing: Conduct comprehensive quality audits of inbound and outbound call center interactions, ensuring accuracy, regulatory compliance, and adherence to TPA standard operating procedures.
  • Form Review: Review and audit completed service and administrative forms (e.g., policy changes, beneficiary updates) for completeness, accuracy, and proper processing workflow.
  • Feedback & Coaching: Deliver timely, objective, and constructive feedback and coaching to call center agents and team leads to improve service quality and transaction accuracy.
  • Reporting: Track, analyze, and report on key TPA and QA metrics and trends, identifying root causes of errors and compliance gaps.
  • Pre-Referral Case Review: Act as the initial point of contact for internal fraud referrals (SIU). Review and analyze cases flagged for potential fraudulent activity, including claims, policy changes, and applications.
  • Evidence Gathering: Collect, organize, and summarize documentation and system history related to suspicious cases.
  • Triage & Escalation: Conduct preliminary analysis to determine the validity of the fraud concern. Prepare and present well-documented case files for formal referral to the insurance carrier's Special Investigations Unit (SIU).
  • Documentation: Maintain detailed and confidential records of all investigation activities and findings in accordance with internal protocol and regulatory requirements.
  • Control Monitoring: Execute periodic and event-based monitoring of defined key operational and financial controls within the TPA processing environment to confirm effectiveness.
  • Risk Reporting: Assist in the reporting of control gaps, deficiencies, and emerging risks to the Risk and Compliance leadership.
  • Process Improvement: Collaborate with Operations and Training teams to develop and implement targeted process changes, control enhancements, and improved documentation to mitigate identified risks.
  • Training Support: Assist in the development and delivery of training modules related to compliance, fraud awareness, and new quality standards for operations, quality assurance and TPA contact center staff.

WHO YOU ARE
  • Minimum of 2 years of professional experience in Quality Assurance (QA), Compliance, Fraud Analysis, or an operational role within the life insurance, financial services, or TPA industry.
  • Strong working knowledge of life insurance policy lifecycle, administrative forms, and general TPA operating procedures.
  • Proven ability to analyze complex transaction histories, identify unusual patterns, and draw sound conclusions for risk and fraud assessment.
  • Exceptional verbal and written communication skills, with the ability to deliver difficult feedback constructively and concisely summarize investigation findings for executive review.
  • Experience with a formal quality monitoring system (e.g., call recording, QA software) preferred
  • Familiarity with state and federal regulations governing life insurance (e.g., anti-money laundering, privacy) preferred
  • Experience in conducting internal control audits (SOX, SOC) preferred
  • Experience creating quality assurance checklists within QA systems preferred

TOTAL REWARDS
At Bestow, we're proud to be awarded for our team members, innovative products, and culture. Our standard benefits include:
  • Competitive salary and equity based on role
  • Policies and managers that support work/life balance, like our flexible paid time off and parental leave programs
  • 100% paid-premium option for medical, dental, and vision insurance
  • Lifestyle stipend to support your physical, emotional, and financial wellbeing
  • Flexible work-from-home policy and open to remote
  • Remote and WFH options, as well as a beautiful, state-of-the-art office in Dallas' Deep Ellum, for those who prefer an office setting
  • Employee-led diversity, equity, and inclusion initiatives

Recent Employer Awards include:
  • Best Place for Working Parents 2023 + 2024 + 2025
  • Great Place to Work Certified, 2022 + 2023 + 2024 + 2025
  • Built In Best Places to Work, 2022 + 2023 + 2025
  • Fortune's Best Workplaces in Texas 2022 + 2023
  • Fortune's Best Workplaces in Financial Services and Insurance 2022 + 2023 + 2024

We value diversity at Bestow. The company will hire, recruit, and promote regardless of race, color, religion, sex, sexual orientation, gender identity or expression, national origin, pregnancy or maternity, veteran status, or any other status protected by applicable law. We understand the importance of creating a safe and comfortable work environment and encourage individualism and authenticity in every team member.
Thanks for considering a job at Bestow!

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